Fatigue: Biomedicine, Health & Behavior - Volume 4, Issue 1, 2016

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Titles and abstracts for the journal, Fatigue: Biomedicine, Health & Behavior, Volume 4, Issue 1, 2016.

Volume 4, Issue 1, 2016[edit | edit source]

  • Case definitions integrating empiric and consensus perspectives (FULL TEXT)
    Abstract - Background: There has been considerable controversy regarding how to name and define the illnesses known as myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). The Institute of Medicine (IOM) report has proposed new clinical criteria and a new name for this illness, but aspects of these recommendations have been scrutinized by patients and scientists. Purpose: It is possible that both empiric and consensus approaches could be used to help settle some of these diagnostic challenges. Using patient samples collected in the USA, Great Britain, and Norway (N = 556), the current study attempted to categorize patients using more general as well as more restricted case definitions. Results: Overall, the outcomes suggest that there might be four groupings of patients, with the broadest category involving those with chronic fatigue (N = 62), defined by six or more months of fatigue which cannot be explained by medical or psychiatric conditions. A second category involves those patients who have chronic fatigue that can be explained by a medical or psychiatric condition (N = 47). A third category involves more specific criteria that have been posited both by the IOM report, Canadian Clinical Case criteria, ME-ICC criteria and a more empiric approach. These efforts have specified domains of substantial reductions of activity, post-exertional malaise, neurocognitive impairment, and sleep dysfunction (N = 346). Patients with these characteristics were more functionally impaired than those meeting just chronic fatigue criteria, p < .05. Finally, those meeting even more restrictive ME criteria proposed by Ramsay, identified a smaller and even more impaired group, p < .05. Conclusion: It is important that scientists world-wide develop consensus on how to identify and classify patients using clinical and research criteria, and ultimately develop subtypes within such categories.[1]
  • In-depth review of five fatigue measures in shift workers (FULL TEXT)
    Abstract - Background: Occupational fatigue is commonly reported in shift-working populations. In the literature, there are several well-known fatigue measures that are regularly used to assess either general or specific aspects of employee fatigue. Purpose: The purpose of this paper was to provide an in-depth review of five fatigue instruments frequently used in occupational science over the past two decades. These instruments are: the Checklist Individual Strength, the Fatigue Assessment Scale, the Need for Recovery, the Occupational Fatigue Exhaustion Recovery, and the Swedish Occupational Fatigue Inventory scales. We describe each instrument in detail, including how it was developed and validated, how it can be obtained, psychometric data, and its use in occupational studies. Conclusion: These instruments provide an understanding of fatigue either as a unidimensional or multidimensional construct. Overall, the five measures are brief (10–20 items), user-friendly, and have minimal respondent and administrative burden. They are reliable and valid based on the psychometric studies in the working population. Each measure has the potential to be utilized as a surveillance tool in monitoring employee fatigue and ensuring workplace safety. Selecting one or combination of these measures depends on the researcher's conceptual and operational definitions of fatigue, and the study objectives.[2]
  • Current therapeutic strategies for myalgic encephalomyelitis/chronic fatigue syndrome: results of an online survey (FULL TEXT)
    Abstract - Background: The treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms poses significant challenges. Purpose: To enumerate current clinical treatment strategies for ME/CFS. Methods: A survey was deployed via the Internet to eleven expert clinicians in ME/CFS. The experts rated medications for 18 symptoms and listed symptom groups that they considered as interrelated and representative of different ME/CFS phenotypes. Respondents rated drug efficacy on an ordinal scale (1 = very effective to 5 = not effective). Free text was also permitted to comment on treatment strategies and ME/CFS phenotypes. Results: Data were available for 11/20 respondents. Citalopram was reported to be more than moderately effective for depression/anxiety and similarly fentanyl for muscle aches and arthralgias. Low-dose stimulants and low-dose bupriopion were viewed as effective for fatigue by five respondents. Regarding ME/CFS phenotypes, respondents suggested that (a) sleep improvement can ameliorate post-exertional malaise, pain and headache, (b) treatment of orthostatic intolerance can improve fatigue, light headedness, mental fog, headache and pain, while (c) epigastric pain, reflux, and early satiety may suggest nutritional hypersensitivity. Conclusion: The views of ME/CFS experts regarding treatment strategies and drug efficacy can aid clinicians in the optimization of their practices, and perhaps can steer ME/CFS research in directions that hold promise.[3]
  • Comparing the DePaul Symptom Questionnaire with physician assessments: a preliminary study (FULL TEXT)
    Abstract - Background: Diagnostic assessment of chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) is largely based on a two part process; screening patients who might meet criteria and following up this assessment with physicians’ clinical evaluation of a range of inclusionary symptoms and exclusionary illnesses. Purpose: The aim was to assess how well the DePaul Symptom Questionnaire (DSQ) screened for patients who were ultimately diagnosed by physicians using the Canadian Consensus Criteria (CCC). Methods: Sixty-four patients referred for evaluation of possible CFS or ME were screened initially using the DSQ, and then evaluated and subsequently diagnosed by physicians. To assess the consistency between the self-report DSQ and the physicians’ diagnosis, sensitivity and specificity as well as predictive values were calculated. Results: The DSQ identified 60 and the physicians identified 56 as having a CCC diagnosis. The overall agreement between the two ratings on the diagnostic assessment part was moderate (Kappa = 0.45, p < .001). The sensitivity of DSQ was good (98%) while the specificity was 38%. Positive and negative predictive values were 92% and 75%, respectively. Conclusion: DSQ is useful for detecting and screening symptoms consistent with a CCC diagnosis in clinical practice and research. However, it is important for initial screening of self-report symptoms to be followed up by subsequent medical and psychiatric examination in order to identify possible exclusionary medical and psychiatric disorders.[4]

See also[edit | edit source]

References[edit | edit source]

  1. Jason, L. A.; McManimen, S.; Sunnquist, Madison; Brown, A.; Furst, J.; Newton, J. L.; Strand, E. B. (2016), "Case definitions integrating empiric and consensus perspectives", Fatigue: Biomedicine, Health & Behavior, 4 (1): 1-23, doi:10.1080/21641846.2015.1124520 
  2. Sagherian, K., & Geiger Brown, J. (2016). In-depth review of five fatigue measures in shift workers. Fatigue: Biomedicine, Health & Behavior, 4 (1), 24-38. doi:10.1080/21641846.2015.1124521
  3. Deftereos, S. N., Vernon, S. D., & Persidis, A. (2016). Current therapeutic strategies for myalgic encephalomyelitis/chronic fatigue syndrome: results of an online survey. Fatigue: Biomedicine, Health & Behavior, 4 (1), 39-51. doi:10.1080/21641846.2015.1126025
  4. Strand, Elin B.; Lillestøl, Kristine; Jason, Leonard A.; Tveito, Kari; Diep, Lien My; Valla, Simen Strand; Sunnquist, Madison; Helland, Ingrid B.; Dammen, Toril (2016), "Comparing the DePaul Symptom Questionnaire with physician assessments: a preliminary study.", Fatigue: Biomedicine, Health & Behavior, 4 (1): 52-62, doi:10.1080/21641846.2015.1126026 

Institute of Medicine report (IOM report) - A report that was commissioned by the U.S. government and was published by the Institute of Medicine on February 10, 2015. The report was titled "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" and proposed the term Systemic Exertion Intolerance Disease (SEID). Among its key findings were that "This disease is characterized by profound fatigue, cognitive dysfunction, sleep abnormalities, autonomic manifestations, pain, and other symptoms that are made worse by exertion of any sort." The report further stated "Between 836,000 and 2.5 million Americans suffer from myalgic encephalomyelitis/chronic fatigue syndrome."

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

International Consensus Criteria (ICC) - A set of diagnostic criteria, based on the Canadian Consensus Criteria, that argued for the abandonment of the term "chronic fatigue syndrome" and encouraged the sole use of the term "myalgic encephalomyelitis".

ME/CFS - An acronym that combines myalgic encephalomyelitis with chronic fatigue syndrome. Sometimes they are combined because people have trouble distinguishing one from the other. Sometimes they are combined because people see them as synonyms of each other.

orthostatic intolerance (OI) - The development of symptoms when standing upright, where symptoms are relieved upon reclining. Patients with orthostatic intolerance have trouble remaining upright for more than a few seconds or a few minutes, depending upon severity. In severe orthostatic intolerance, patients may not be able to sit upright in bed. Orthostatic intolerance is often a sign of dysautonomia. There are different types of orthostatic intolerance, including postural orthostatic tachycardia syndrome (POTS).

lightheadedness - the condition of being dizzy or on the verge of fainting

Canadian Consensus Criteria (CCC) - A set of diagnostic criteria used to diagnose ME/CFS, developed by a group of practicing ME/CFS clinicians in 2003. The CCC is often considered to be the most complex criteria, but possibly the most accurate, with the lowest number of patients meeting the criteria. Led to the development of the International Consensus Criteria (ICC) in 2011.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

chronic fatigue syndrome (CFS) - A fatigue-based illness. The term CFS was invented invented by the U.S. Centers for Disease Control as an replacement for myalgic encephalomyelitis (ME). Some view CFS as a neurological disease, others use the term for any unexplained long-term fatigue. Sometimes used as a the term as a synonym of myalgic encephalomyelitis, despite the different diagnostic criteria.

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